title: Electroconvulsive therapy increases hippocampal and amygdala volume in therapy refractory depression: a longitudinal pilot study.
abstract: Electroconvulsive therapy (ECT) is the most potent biological therapy in depression. Animal studies suggest that ECT acts via neuroplasticity effects on limbic structures involved in the pathophysiology of depression but in vivo evidence at the human system level is scarce. Therefore, the aim of the present study was to investigate the effect of ECT on hippocampus and amygdala volume in 15 antidepressant-free patients with treatment refractory depression (seven males, range 42-63 years). ECT treatment was successful as indexed by a significant decrease in depressive symptoms (t14=13.6; p<0.001). Analysis of normalized volumetric data before and after ECT treatment revealed a significant volume increase of both hippocampus and amygdala (minimum p<0.005) with no evidence for a change in global brain volume. Though this change in volume cannot be clearly related to treatment effects, ECT is associated with broader neurotrophic effects other than mere adult neurogenesis in the hippocampus, which has been previously suggested as a core mechanism on the basis of animal data.
authors.affiliation: Department of Psychiatry, Radboud University Medical Center, Postbus 9101, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain Cognition and Behavior, Centre for Neuroscience, Nijmegen, The Netherlands; Faculty of Medicine and LVR Clinic for Psychiatry and Psychotherapy, University of Duisburg-Essen, Germany. Electronic address: i.tendolkar@psy.umcn.nl.
authors.forename: Indira
authors.initials: I
authors.lastname: Tendolkar
authors.forename: Marleen
authors.initials: M
authors.lastname: van Beek
authors.forename: Iris
authors.initials: I
authors.lastname: van Oostrom
authors.forename: Marlies
authors.initials: M
authors.lastname: Mulder
authors.forename: Joost
authors.initials: J
authors.lastname: Janzing
authors.forename: Richard Oude
authors.initials: RO
authors.lastname: Voshaar
authors.forename: Philip
authors.initials: P
authors.lastname: van Eijndhoven
mesh_terms: D000328:Adult; D000679:Amygdala / Q000473:pathology*; D061218:Depressive Disorder, Treatment-Resistant / Q000473:pathology*; D004565:Electroconvulsive Therapy; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009473:Neuronal Plasticity; D009929:Organ Size; D010865:Pilot Projects
keywords: Amygdala; Depression; ECT; Hippocampus; Structural magnetic resonance imaging (sMRI)